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For Black parents with postpartum depression, help can be difficult to find

Maroon Calabash, a Black doula collaborative in the Milwaukee area, pairs new mothers with a postpartum doula and charges on a sliding scale.

Symphony Zawadi poses for a portrait at her home on Jan. 14 in Milwaukee. Zawadi suffered from postpartum depression and contracted covid-19 after giving birth to her daughter. (Joshua Lott/The Washington Post)
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Bethany Riddick began experiencing symptoms of postpartum depression nearly immediately after the birth of her son in March 2020.

She didn’t want to watch television, read books, go for walks or even step onto the balcony of her Milwaukee apartment. Lockdown restrictions had just started in Wisconsin to slow the spread of the coronavirus, making her feel even more isolated. With her mother living in another state, she largely spent her postpartum days alone.

“I didn’t really have interest in anything,” said Riddick, 25. “Some days, I couldn’t pull myself out of bed, except to care for my son.”

When Riddick began having thoughts of suicide, she researched mental health providers in the area. Many providers were not accepting new patients, and those with availability wouldn’t accept her insurance.

“When I told them I had state insurance or that I would need a mental health professional that operated on a sliding scale, these agencies would immediately become very cut and dry and bluntly state that my insurance wasn’t covered,” Riddick said. “I would ask if they could provide resources for low-income folks dealing with mental health issues, and I would be addressed in a condescending tone, instead of actually receiving help.”

A friend connected her to Maroon Calabash, a Black doula collaborative started in 2016 that provides prenatal, birth and postpartum support for Black families in and around the Milwaukee area.

After a virtual consultation, Riddick was paired with a postpartum doula who spent three to eight hours with her each day for about six months. Riddick didn’t have to pay anything for the support. She and her doula cooked, journaled, danced, did yoga and exercised together. Her doula would hold the baby so she could nap or have some quiet time alone. Once, she detangled Riddick’s hair for her because she was too exhausted to do it herself.

“It was definitely that moment when I shed a few tears … [because] this person [was] loving on me and not judging me, ” Riddick said. “It was intimate, it felt almost like a sisterhood.”

While 1 in 7 women experience postpartum mood disorders after the birth of their children, researchers have found that Black and Latina women may be particularly vulnerable to developing postpartum mood and anxiety disorders.

A 2005 study from the Icahn School of Medicine at Mount Sinai in New York City found that 44 percent of Black women and nearly 47 percent of Hispanic women reported postpartum depressive symptoms compared to 31 percent of White women. The study was based on a telephone survey of 655 White, African American and Hispanic mothers who had given birth two to six weeks earlier.

Systemic racism, lack of access to mental health providers and financial challenges are factors that may make the postpartum experiences of Black women all the more challenging, said Lyanne Jordan, the co-founder and executive director of Maroon Calabash.

The challenges facing Black parents have been compounded by the pandemic and the uncertainty of raising a Black baby in a world where “we’re marching in the millions, but we’re still getting gunned down,” she said.

Before the summer of 2020, only about a third of Maroon Calabash’s clients exhibited postpartum mood disorders. Since the pandemic began and protests of police brutality intensified, Jordan said that number increased to nearly 100 percent. Since last summer, that percentage has fallen but is still higher than pre-pandemic numbers.

“We saw a lot of parents with postpartum anxiety, a lot of parents scoring very high on postpartum depression screens, in numbers we had not seen in our doulas’ 20 years of experience,” Jordan said.

When Symphony Zawadi, a longtime friend of Jordan, gave birth to her second child in 2016, Maroon Calabash was just an idea. Zawadi recalls even drawing out a few sketches for the organization’s first logo. During her third pregnancy in 2020, Zawadi sought their services and Jordan actually became her postpartum doula for two months.

During the time of her pregnancy, Zawadi was also transitioning jobs amid the pandemic, leaving her without health insurance and fearful about cost. However, Maroon Calabash’s services were free of charge, thanks to grants from the Milwaukee Birthing Access Fund in collaboration with Prism Birth Services, an inclusive community midwifery organization.

“Reaching out to Maroon Calabash was everything that I needed … I tell Lyanne all the time that she was God sent,” says Zawadi, who also contracted covid-19 after giving birth.

In a system that is often not getting Black mothers necessary assistance, nonprofits like Maroon Calabash are filling that void. The House of Representatives Black Maternal Health Caucus has introduced legislation to provide training for about 30,000 doulas and expand postpartum Medicaid coverage from 60 days to 12 months, as part of its Momnibus Act. Portions of this legislation passed as part of the Build Back Better Act in the House in late November, but have yet to pass in the Senate.

“This country has neglected and harmed birthing people, because our systems are not sufficient to care for what people need,” Jordan said.

In addition to providing support in the home, the Maroon Calabash doulas have done their best to plug their clients in with the right resources. They work with the D & S Healing Center, a mental health group owned and run by people of color that consults with birth workers and offers emergency care for clients in need. The doulas developed a live resource document of vetted local Black mental health providers that took Medicaid and were accepting new patients.

“I honestly feel that Maroon Calabash saved my life, in more ways than one,” Riddick said.

Many of the collective’s clients feel the same way and doula programs like it have been praised for helping address disparities. But Jordan cautions that doulas are not a solution to the nation’s postpartum mental health crisis.

“We’re aware of the impact that Black doulas/birth workers have on Black birthing outcomes, but like we always say, ‘Black doulas are not the saviors of Black maternal health.’ Systems of white supremacy must be dismantled for real and sustainable solutions,” Jordan said.

Adeiyewunmi (Ade) Osinubi is a fourth-year medical student at the Warren Alpert Medical School of Brown University, photographer and a documentary film producer. She recently produced Black Motherhood through the Lens, a documentary series about four Black women’s experiences in navigating postpartum mood and anxiety disorders, infertility and childbirth.

To support the work Maroon Calabash does to prioritize the wellness and equitable compensation for Black birth workers and to build networks of care, visit: https://mkebirthingaccess.com/donate.

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